Survey finds employment trends, challenges in the field of electrophysiology

Deering T. Heart Rhythm. 2010; doi:10.1016/j.hrthm.2010.07.026.

Issue: October 2010

Data from a recent survey have shown that work capacity increases and concerns over competition are some of the most cited changes to the field of electrophysiology mentioned by physician respondents since the last workforce study in 2001.

The survey consisted of a series of comprehensive questionnaires developed by the Heart Rhythm Society (HRS) Workforce Study Task Force, which were filled out by physicians, allied professionals and basic science researchers. The questionnaires were administered online from April 23 to May 18, 2009, to both physician members (n=2,423) of HRS and physician non-members (n=4,598) in the United States and Canada.

Of the responding physicians (n=695, 9.9%), 41% said they worked 50 to 60 hours per week, with 29% saying they worked 61 to 75 hours per week (median work week, 60 hours). Participants for every respondent age-range queried expected the volume of work during the next 5 years to increase. Most of the respondents (81%) showed concern over competition, with 37% noticing “a great deal” of competition and 44% noticing “some competition,” which may dilute operator experience, according to researchers.

Additional survey data showed that compared with 5 years ago, the total number of implantation procedures performed by respondents increased substantially in 26.1% of physicians, somewhat in 29.3% and stayed the same in 29%. Furthermore, 65% of physician respondents claimed they had made a geographic change since completing training — the remaining 35% stayed in the same state in which they trained — with the Northeast cited as having the highest rate of trained physicians (54%).

“Although specific areas will require further analysis, overall, the current electrophysiology/electrophysiologist is stable, with the exception of geographic dispersion,” the researchers wrote in their study. “However, the workforce must adapt to the key economic drivers — demand — and address future recruitment challenges.”

Deering and colleagues provide important insights into current electrophysiology practice. Unfortunately, less than 10% of those invited participated in the survey, and this, of course, limits the strength of the data. Regardless, the paper brings to attention the increasingly complex nature of electrophysiology practice, and in that context, the authors note that although one-third of the respondents reported an ability to increase their work load, the long hours currently worked and our profession's increasing age suggest that perception may not match the clinical demand. This is an even more pressing issue given an imperative for finding mechanisms to bring advanced technologies to underserved areas. As the authors observe, more questions than answers are given, including whether or not outcomes will be altered by health care reform and practice patterns, especially with non-physicians taking a greater role in patient care for complex arrhythmias.

– Andrew E. Epstein, MD
Cardiology Today Editorial Board

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